Endocrine Abstracts

Somatostatin analogues (SSAs) are regularly used in the treatment of neuroendocrine tumours (NETs) to control the symptoms of hormonal hypersecretion. Evidence shows that SSAs can reduce tumour progression, and are therefore also being used in patients with non-functioning tumours. As many NETs present with advanced disease curative therapy is often not possible; therefore, assessing the impact of therapy on quality of life (QoL) is vital to patient management. This is particu...

Introduction The diagnosis of carcinoid heart disease (CHD) is often made late and the patients are often deconditioned, with symptoms of fatigue, weight loss and refractory carcinoid symptoms. The challenge is then to improve the patient's condition by an enhanced pathway of prehabilitation and interventions, in order to consider surgical and medical therapies that can improve the patient's quality of life and prognosis. In 2018 due to the complexity of patients and increased...

Introduction: The Birmingham Neuroendocrine Tumour (NET) and Carcinoid Heart Disease( CHD) services evolved into a combined and bespoke specialist service in 2018, with the introduction of the enhanced CHD pathway. This involved discussion at the CHD NET MDT , CHD work-up in the inpatient or outpatient setting and a clinical review in the bespoke CHD NET clinic. The CHD NET pathway is now embedded and well-established at our centre. We have a consistent flow o...

A 63-year-old Caucasian female was admitted with a 12-month history of exertional breathlessness, anxiety attacks, syncopal episodes, diarrhoea, fatigue, reduced appetite, two stones weight loss, and dry facial and truncal flushing. Investigations revealed raised Urine 5-HIAA of 116 (RR <50 μmol/24 h) and raised Chromogranin A of 48 (RR <6 nmol/l). CT scan revealed an extensive soft tissue mass encasing the upper abdominal aorta, compressing the inferior vena cava...

Introduction: MEN1 associated pNETs share a unique profile in comparison to sporadic pNETs. The literature on pNETs in MEN1 is evolving with on-going ambiguities in presentation and management. We present a case series of MEN1 associated pNETs from a tertiary centre of excellence for NETs in the UK.Methods: Institutional NET database was used for retrospective data analysis for all patients with pNETs associated with MEN1.Results: ...

Background: Transplantation for cancer indications is evolving rapidly in UK and Ireland. Liver transplantation [LT] for unresectable neuroendocrine tumour liver metastases [NET LM] is one of three new cancer indications. It has the potential to significantly improve survival outcomes however, transplant benefit has likely been achieved only by highly experienced Centre(s). Since eligible patients for transplantation also have excellent prognosis with standard management, care...

Introduction: The WHO classification distinguishes G3NET as a separate entity. Literature on G3NETs is limited to case-reports and small case-series. We aimed to characterise G3NETs from a large tertiary centre.Methods: Retrospective analysis from NET database: 2012–2019. All referrals are discussed at a specialist NET-MDT before entry into clinical pathway. Core NET-MDT consists of a radiologist, nuclear-medicine radiologist, histopathologist, spec...

Introduction Chronic heart failure is a catabolic state leading to cachexia in 5-15% of patients, predicting poor survival outcomes. Malnutrition affects 40% of patients with NETs and 58% with carcinoid syndrome (CS). Case 45M with severe carcinoid heart disease, on referral and admission was cachectic with BMI of 16, having lost 32 kg or 30% of body weight, meeting 50% of dietary requirements and at risk of refeeding syndrome. Nasogastric feeding (NG) w...

Introduction: Here we present our experience of managing patients with orbital well-differentiated neuroendocrine tumour (NET) metastases.Methods: Six patients were identified from the hospital NET database: four male; two female.Results: Median age at diagnosis of primary NET: 69.5 years (range: 40-74 years). Three patients were alive at time of data capture. Of those who passed away: mean survival from diagnosis of primary NET = ...

Carcinoid syndrome occurs in 20% patients, presenting with flushing, abdominal pain, diarrhoea, and wheeze and can be challenging to manage. The standard of care for carcinoid syndrome is somatostatin analogues (SSAs) with add-on Creon, codeine and loperamide therapy. Nonetheless, half of patients experience debilitating diarrhoea. Telotristat-ethyl is a peripheral tryptophan-hydroxylase inhibitor approved for treatment of diarrhoea, supported by Phase 3 clinical trials but la...